Missouri 2026 Regular Session Status: Passed House 1 R cosponsors

HB 2600 — Modifies provisions relating to ambulance districts

Last action — Placed on Informal Calendar

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  1. ✓
    Introduced
  2. ✓
    In Committee
  3. 3
    Passed House
  4. 4
    Passed Senate
  5. 5
    To Executive
  6. 6
    Enacted

This bill has passed the House. Introduced December 29, 2025. It now moves to the second chamber.

Next likely step: consideration and a floor vote in the Senate.

Prognosis

Advancing 48% · moderate confidence

Where this bill stands today.

Odds of enactment

Moderate

How often bills like it became law.

  • Passed House

    Current position in the legislative process.

  • 1 sponsor

    1 primary, 0 co-sponsors signed on.

  • Single-party support

    Sponsorship is currently within one party (1 R).

  • Cleared a recorded vote

    Passed 3 recorded votes so far.

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

In plain language

The bill modifies the governance structure of ambulance districts in Missouri.

This bill updates the election process and terms for directors of ambulance districts in Missouri. It introduces provisions for both district-specific and at-large elections for directors.

Bill Text

What changed in the latest version

104 added · 100 removed

Plain-language change summary

The recent amendment to Bill HB 2600 has changed the number of new sections related to ambulance districts from five to six, while also clarifying the structure of elections within those districts. This change is important because it allows for a better representation of voters in larger counties, ensuring that each election district is as equal in population as possible. Additionally, it streamlines the process for when no election is needed, allowing candidates to assume office directly if there are no competing candidates. Overall, these modifications aim to enhance the governance and functionality of ambulance districts in populous areas.

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SECOND REGULAR SESSION HOUSE COMMITTEE SUBSTITUTE FOR HOUSE BILL NO.
SECOND REGULAR SESSION [PERFECTED WITH PERFECTING AMENDMENT] HOUSE COMMITTEE SUBSTITUTE FOR HOUSE BILL NO.
2600 103RD GENERAL ASSEMBLY 4533H.03C JOSEPH ENGLER, Chief Clerk AN ACT To repeal sections 190.050, 190.051, 190.052, 190.070, and 190.090, RSMo, and to enact in lieu thereof five new sections relating to ambulance districts.
2600 103RD GENERAL ASSEMBLY 4533H.03D JOSEPH ENGLER, Chief Clerk AN ACT To repeal sections 190.050, 190.051, 190.052, 190.070, and 190.090, RSMo, and to enact in lieu thereof six new sections relating to ambulance districts.
Sections 190.050, 190.051, 190.052, 190.070, and 190.090, RSMo, are repealed and five new sections enacted in lieu thereof, to be known as sections 190.050, 190.051, 190.052, 190.070, and 190.090, to read as follows:
Sections 190.050, 190.051, 190.052, 190.070, and 190.090, RSMo, are repealed and six new sections enacted in lieu thereof, to be known as sections 190.050, 190.051, 190.052, 190.070, 190.089, and 190.090, to read as follows:
After the ambulance district has been declared organized, the declaring county commission[, except in counties of the second class having more than one hundred five thousand inhabitants located adjacent to a county of the first class having a charter form of government which has a population of over nine hundred thousand inhabitants, shall divide the district into six election districts as equal in population as possible, and shall by lot number the districts from one to six inclusive.
After the ambulance district has been declared organized, the declaring county commission[, except in counties of the second class having more than one hundred five thousand inhabitants located adjacent to a county of the first class having a charter form of government which has a population of over nine hundred thousand inhabitants,] shall divide the district into six election districts as equal in population as possible[, and] or provide for the election of six directors elected at large from within the district.
The county commission shall cause an election to be held in the ambulance district within ninety days after the order establishing the ambulance district to elect ambulance district directors.
(1) If the county commission divides the district into election districts, the commission shall by lot number the districts from one to six inclusive.
The county commission shall cause an election to be held in the ambulance district on the next regularly scheduled election date [within ninety days] after the order establishing the ambulance district to elect ambulance district directors.
The county commission shall reapportion the ambulance districts within sixty days after the population of the county is reported to the governor for each decennial census of the United States.
The EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is intended to be omitted from the law.
Notwithstanding any other provision of law, if the number of candidates for the office EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is intended to be omitted from the law.
HCS HB 2600 2 of director is no greater than the number of directors to be elected, no election shall be held, and the candidates shall assume the responsibilities of their offices at the same time and in the same manner as if they have been elected.
HCS HB 2600 2 county commission shall reapportion the ambulance districts within sixty days after the population of the county is reported to the governor for each decennial census of the United States.
2.
Notwithstanding any other provision of law, if the number of candidates for the office of director is no greater than the number of directors to be elected, no election shall be held, and the candidates shall assume the responsibilities of their offices at the same time and in the same manner as if they have been elected.
In all counties of the second class having more than one hundred five thousand inhabitants located adjacent to a county of the first class having a charter form of government which has a population of over nine hundred thousand inhabitants,] shall order an election be held on the next regularly scheduled election date and the voters shall vote for six directors elected at large from within the district for a term of three years.
[2.
In all counties of the second class having more than one hundred five thousand inhabitants located adjacent to a county of the first class having a charter form of government which has a population of over nine hundred thousand inhabitants,] (2) If the county commission provides for an at large board of directors, it shall order an election be held on the next regularly scheduled election date and the voters shall vote for six directors elected at large from within the district for a term of three years.
If the time between the county commission's call for a special election and the date of the election is not sufficient to allow compliance with subsection 5 of section 115.127, the county commission shall, at the time it calls the special election, set the closing date for filing declarations of candidacy.
If the time between the county commission's call for a special election and the date of the election is not sufficient to allow compliance with subsection 5 of section 115.127, the HCS HB 2600 3 county commission shall, at the time it calls the special election, set the closing date for filing declarations of candidacy.
Any ambulance district may adopt and establish election subdistricts by ordinance, providing that each election subdistrict shall be composed of contiguous territory as compact and as nearly equal in population as may be, and that each board HCS HB 2600 3 member shall be a resident of the election subdistrict that they represent at the time of their election and for the duration of their term.
An ambulance district may, following a public hearing subject to the provisions of chapter 610, by an ordinance adopted by an affirmative vote of two-thirds of the members of the board of directors, abolish the boundaries of any existing election subdistricts if the board is unable to find a qualified candidate to fill the director position of each such subdistrict.
Such ordinance shall only be adopted, amended, or repealed by a two-thirds majority vote of the board of directors.
Such ordinance may eliminate the subdistricts entirely and provide for the election of directors at large.
A copy of the ordinance shall be filed with the county clerk.
Upon the abolition of such election subdistricts, all current directors shall serve as directors at large for the remainder of their existing terms.
Any ambulance district may, by an ordinance adopted by an affirmative vote of two thirds of the members of the board of directors, establish election subdistricts.
Each election subdistrict shall consist of contiguous territory and shall be as compact and nearly equal in population as practicable.
The boundaries of such subdistricts shall be established by the county commission.
Each board member shall be a resident of the election subdistrict that he or she represents at the time of election and shall remain a resident of such subdistrict for the duration of the member's term.
5.
Shall the number of members of the board of directors of the ______ (Insert name of district) Ambulance District be (increased to seven members/decreased to five members/decreased to three members)? YES NO [2.] 3.
Shall the number of members of the board of directors of the ______ (Insert name of district) Ambulance District be (increased to seven members/decreased to five members/decreased to three members)? YES NO HCS HB 2600 4 [2.] 3.
If a majority of the voters voting on a proposition to decrease the number of board members vote in favor of the proposition, then the [county clerk shall redraw the district into the resulting number of subdistricts with equal population bases and hold elections by subdistricts pursuant to section 190.050] existing board members stated in the board resolution shall complete the terms specified therein.
If a majority of the voters voting on a proposition to decrease the number of board members vote in favor of the proposition, then the county clerk shall redraw the district into the resulting number of subdistricts with equal population bases and hold elections by subdistricts pursuant to section 190.050.
Members of the board of directors in office on the date of an election pursuant to this section to increase or decrease the number of members of the board of directors shall HCS HB 2600 4 serve the term to which they were elected or appointed and until their successors are elected and qualified.] 190.052.
Members of the board of directors in office on the date of an election pursuant to this section to increase or decrease the number of members of the board of directors shall serve the term to which they were elected or appointed and until their successors are elected and qualified.] 190.052.
A petition for annexation of land to an ambulance district shall be signed by not less than ten percent or fifty voters, whichever is fewer, residing within the territory therein described proposed for annexation and shall be [filed with the county clerk of the county in which the district or the greater portion thereof is situated, and shall be addressed to the commissioners of the county commission] presented to the board of directors of the ambulance district.
A petition for annexation of land to an ambulance district shall be signed by not less than ten percent or fifty voters, whichever is fewer, residing within the territory therein described proposed for annexation and shall be filed with the county clerk of the county in which the district or the greater portion thereof is situated, and shall be addressed to the commissioners of the county commission.
A hearing shall be held thereon as nearly as possible as in the case of a formation petition.
A hearing shall be held thereon [as nearly as possible as in the case of a formation petition] within thirty days of the filing of such petition.
If upon the hearing the [commissioners of the county commission find] board of directors finds that the petition is in compliance with the provisions of sections 190.005 to 190.085, they shall order the question to be submitted to the voters within the territory and within the district.
If upon the hearing the commissioners of the county commission find that the petition is in compliance with the provisions of sections 190.005 to 190.085, they shall order the question to be submitted to the voters within the territory and within the district.
2.
HCS HB 2600 5 2.
Shall ______ (description of territory) be annexed to the ______ ambulance district, and a tax imposed within such annexed area equal to the existing rate of the _____ ambulance district? 3.
Shall______ (description of territory) be annexed to the ______ ambulance district, and a tax imposed within such annexed area equal to the existing rate of the _____ ambulance district? 3.
If a majority of the votes cast on the question [in the district and in the territory described in the petition, respectively,] are in favor of the annexation, the [commissioners of the county commission shall by order declare] board of directors shall enact an ordinance incorporating the territory annexed and shall describe the altered boundaries of the district.
If a majority of the votes cast on the question [in the district and in the territory described in the petition, respectively,] are in favor of the annexation, the commissioners of the county commission shall, within thirty days of the certification of the election results, by order declare the territory annexed and shall describe the altered boundaries of the district.
190.089.
Upon voter approval of an ambulance district consolidation at an election, the department shall prioritize and expedite any activities necessary to facilitate the consolidation.
HCS HB 2600 5 2.
2.
In the event that the proposed plan is for the consolidation into an existing district, the consolidation plan shall clearly state that the existing district shall continue as the legal entity into which the other districts are consolidated;
In the event that the proposed plan is for the consolidation into an HCS HB 2600 6 existing district, the consolidation plan shall clearly state that the existing district shall continue as the legal entity into which the other districts are consolidated;
and HCS HB 2600 6 (5) A proposed time line for consolidation, which shall not exceed one hundred eighty days, provided that such time line shall be subject to modification by the board of the consolidated district for good cause.
and (5) A proposed time line for consolidation, which shall not exceed one hundred eighty days, provided that such time line shall be subject to modification by the board of the consolidated district for good cause.
Within thirty days after the election of the initial board of directors of the district, the directors shall meet and the time and place of the first meeting of the board shall be designated by the county commission.
Within thirty days after the election of the initial board of directors of the district, the directors shall meet and the time and place of the first meeting of the board shall be HCS HB 2600 7 designated by the county commission.
In addition, publication of such notice of intent shall be made in a newspaper of general circulation in every county in which the proposed consolidated ambulance district shall HCS HB 2600 7 be located, with publication to be made once per week for two consecutive weeks.
In addition, publication of such notice of intent shall be made in a newspaper of general circulation in every county in which the proposed consolidated ambulance district shall be located, with publication to be made once per week for two consecutive weeks.
A public hearing shall be held jointly by all ambulance districts seeking to consolidate at a location within the boundaries of the proposed consolidated ambulance district, provided that such hearing shall be no more than ten days after the date of the second publication.
A public hearing shall be held jointly by all ambulance districts seeking to consolidate at a location within the boundaries of the proposed consolidated ambulance district, provided that such hearing shall be no more than thirty days after the date of the second publication.
Any such objection must be signed by a number of voters residing in the proposed consolidated district that is not less than five percent of the votes cast for governor in the district in the most recent gubernatorial election.
Any such objection must be signed by a number of voters residing in the proposed consolidated HCS HB 2600 8 district that is not less than five percent of the votes cast for governor in the district in the most recent gubernatorial election.
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HCS HB 2600 8 Shall the existing ______ ambulance districts be consolidated into one ambulance district to be known as the _________ Ambulance District, with such consolidated district authorized to levy a property tax not to exceed the annual rate of ______ cents on the hundred dollars assessed valuation or a sales tax in an amount not to exceed ______ percent, or a combination of both? If the county commission having jurisdiction finds that the question to consolidate the districts received a majority of the votes cast, the commission shall make and enter its order declaring that the proposition passed.
Shall the existing ______ ambulance districts be consolidated into one ambulance district to be known as the _________ Ambulance District, with such consolidated district authorized to levy a property tax not to exceed the annual rate of ______ cents on the hundred dollars assessed valuation or a sales tax in an amount not to exceed ______ percent, or a combination of both? If the county commission having jurisdiction finds that the question to consolidate the districts received a majority of the votes cast, the commission shall make and enter its order declaring that the proposition passed.
Without a vote of the residents of the consolidated district as provided in this section, no consolidated ambulance district shall be permitted to impose a property tax greater than the lowest of any existing property tax rate of the districts to be consolidated, nor shall the consolidated ambulance district be permitted to impose any sales tax greater than the lowest of any existing sales tax rate of the districts to be consolidated.
Without a vote of the residents of the consolidated district as provided in this section, no consolidated ambulance district shall be permitted to impose a property tax greater than the lowest of any existing property tax rate of the districts to be consolidated, nor shall the consolidated ambulance district be permitted to impose any HCS HB 2600 9 sales tax greater than the lowest of any existing sales tax rate of the districts to be consolidated.
13.
Any ambulance district that has contracted for ambulance service with another ambulance district for more than five consecutive years may submit a joint resolution executed by the boards of both ambulance districts to the county clerk of the county in which the larger area of the proposed consolidated district is located, HCS HB 2600 9 requesting consolidation of said districts by consolidating the smaller districts into the larger district.
Such resolution shall be accompanied by a consolidation plan as provided in this section.
Upon the receipt of such joint resolution, the county commission shall promptly order the smaller districts consolidated into the larger district pursuant to the terms of the consolidation plan without the necessity of providing notice or public hearing.
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Amendments

2 amendments

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Action History

  1. Placed on Informal Calendar

  2. Reported Do Pass (S)

  3. Voted Do Pass (S)

  4. Executive Session Held (S)

  5. Public Hearing Held (S)

  6. Public Hearing Scheduled (S) - Tuesday, April 7, 2026, 1:30 p.m., Senate Committee Room 2 - 1st Floor

  7. Second read and referred: Local Government, Elections and Pensions(S)

  8. Reported to the Senate and First Read (S)

  9. Third Read and Passed with Amendments (H) - HPA 1 - AYES: 148 NOES: 0 PRESENT: 0

  10. Taken Up for Third Reading (H)

  11. Perfected with Amendments (H) - HA 1, adopted

  12. HCS Adopted (H)

  13. Title of Bill - Agreed To

  14. Taken Up for Perfection (H)

  15. Reported Do Pass (H) - AYES: 6 NOES: 0 PRESENT: 0

  16. Voted Do Pass (H)

  17. Executive Session Completed (H)

  18. Referred: Rules - Administrative(H)

  19. HCS Reported Do Pass (H) - AYES: 17 NOES: 0 PRESENT: 0

  20. HCS Voted Do Pass (H)

  21. Executive Session Completed (H)

  22. Public Hearing Completed (H)

  23. Referred: Local Government(H)

  24. Read Second Time (H)

  25. Read First Time (H)

  26. Prefiled (H)

Sponsors

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 198 not signed on

Sponsors (1)

Co-sponsors (0)

None.

Not signed on (198)

198 members have not signed on to this bill.

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"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

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public-safety healthcare
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Frequently asked questions

Who sponsors HB 2600?
HB 2600 is sponsored by Jeff Farnan (Republican).
What is the current status of HB 2600?
This bill has passed the House. Introduced December 29, 2025. It now moves to the second chamber.
Where can I track HB 2600?
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